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Orienting the CPC Year 3 and 4 Student

A good student orientation is the foundation for a successful clerkship experience.

Despite the many efforts of medical educators to help medical students in their transition from the classroom to the clinical setting, engaging in clinical clerkships is still found to be a stress producing learning experience.  In a 1992 study by Moss and McManus, 74 medical students rated 40 potential sources of anxiety associated with clinical clerkships.  The study found interactions with senior medical staff, presenting cases during rounds, and admitting ignorance to clinical teachers to be among the most anxiety producing sources.  A careful examination of the possible sources of anxiety suggests that much of this stress could be reduced through an effective trainee orientation at the start of each clerkship.

This important encounter can take the form of a fifteen minute structured conversation between you and the student very early on day-1 of the clerkship.  This structured time together serves the following functions: (1) helps you and the student get acquainted, (2) facilitates the exploration of the student's interests and learning needs, and (3) gives you the opportunity to set clear expectations.  

As advocates of a more collaborative learning climate, Westberg and Jason (1993) encourage preceptors to think of the orientation as an opportunity to begin the process of establishing a positive relationship with the trainee.  This creates a learning climate that enhances communication between the preceptor and student.

Tips to Enhance the Student Orientation

Be proactive.  Commit to providing an orientation each time a CPC student begins his/her training at your office or hospital service. 

Begin with the end in mind.  Plan and organize the orientation in an outline format.  Include notes that will help you avoid forgetting important details that need elaboration. 

Think win-win.  Communicate to the student that you want him/her to be successful as a learner and that you want to be successful as a teacher.  Say that it is your expectation that both of you will learn from each other. 

Seek to Understand. Ask questions and listen to the student.  Ask about his/her perceived strengths, weaknesses, learning goals, fears, etc.  Also make sure that the orientation includes an opportunity for the student to ask questions.

Synergize.  Involve other colleagues and trainees (e.g. residents) in the  development and delivery of the orientation.

References 

Moss, F. and McManus, C. 1992.  The Anxieties of New Clinical Students.  Journal of Medical Education.  pp.17-20.

Westberg, J. and Jason, H. 1993.  Collaborative Clinical Education. pp73-85.

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